Chinese Medicine: Six Stages of Disease

1. Tàiyáng Stage (太陽)

• Characteristics: Most exterior layer in the body.
• Organs: Small Intestine and Urinary Bladder (not heavily focused on specific organ functions here).
• Key Concepts: Interstices and Pores
  • Interaction between body and environment.
  • No strict boundary between interior and exterior (dynamic exchange).
• Pathogens: Must pass through this stage first.
• Patterns: Cold Damage vs. Wind Strike
  • Cold Damage (Shang Han Cold Damage):
    • Severe chills, mild fever
    • No sweating (pathogen blocking pores)
    • Symptoms: body aches (nape, neck, and back), headache, scratchy throat.
    • Pulse: Floating and tight
    • Signs: No sweating, body aches
    • Treatment Principle: Resolve exterior, promote sweating.
    • Formula: Ma Huang Tang (Ephedra Decoction)
  • Wind Strike (Zhong Feng):
    • Chills and aversion to wind with fever
    • Sweating (due to weakened Wei Qi)
    • Symptoms: body ache, headache, scratchy throat, slight sweating
    • Pulse: Floating and moderate
    • Treatment Principle: Harmonize Ying and Wei levels
    • Formula: Gui Zhi Tang (Cinnamon Twig Decoction)
  • Wind Warmth (Taiyang Wen Bing):
    • More fever than chills
    • Symptoms: sore throat, swollen glands, red tongue with yellow coat
    • Pulse: Rapid
    • Treatment Principle: Clear heat, resolve exterior

2. Shaoyang Stage (少陽)

• Characteristics: Pivot between exterior and interior.
• Organs: Gallbladder and San Jiao
• Key Concepts: Alternating fever and chills
  • Symptoms: bitter taste, dry throat, blurred vision, distension in chest and hypochondrium, irritability
  • Pulse: Wiry
  • Treatment Principle: Harmonize Shaoyang
  • Formula: Xiao Chai Hu Tang (Minor Bupleurum Decoction)

3. Yangming Stage (陽明)

• Characteristics: Interior, heat-rich, deals with Digestive Organs.
• Organs: Stomach and Large Intestine
• Patterns: Channel vs. Organ
  • Yangming Channel Disease:
    • Four Bigs: Big fever, big pulse, big thirst, big sweat
    • No chills
    • Symptoms: High fever, profuse sweating, extreme thirst, red face
    • Pulse: Flooding, big, and forceful
    • Treatment Principle: Clear heat, promote fluids
    • Formula: Bai Hu Tang (White Tiger Decoction)
  • Yangming Organ Disease:
    • Abdominal distension & pain, constipation
    • Symptoms: tidal fever, sweating of hands and feet, dry yellow coat
    • Pulse: Deep, strong, and rapid
    • Treatment Principle: Purge heat accumulation, moisten intestines
    • Formula: Da Cheng Qi Tang (Major Order the Qi Decoction)

4. Taiyin Stage (太陰)

• Characteristics: Related to fluid dynamics and immune functions.
• Organs: Lung and Spleen
• Patterns: Spleen Qi or Yang Deficiency with Dampness
  • Symptoms: Abdominal fullness, vomiting, diarrhea, cold abdomen relieved by warmth/pressure, pale face
  • Tongue: Thick, greasy white coat
  • Pulse: Deep and weak
  • Treatment Principle: Warm and strengthen Spleen, resolve dampness
  • Formula: Li Zhong Wan (Regulate the Middle Pill), Shen Ling Bai Zhu San (Ginseng and Atractylodes Macrocephala Powder)

5. Shaoyin Stage (少陰)

• Characteristics: Deeper, more critical level dealing with Kidney and Heart functions.
• Patterns: Cold Transformation vs. Heat Transformation
  • Cold Transformation:
    • Symptoms: Cold, weak, diarrhea with undigested food
    • Tongue: Pale and wet
    • Pulse: Deep, weak, and slow
    • Treatment Principle: Warm Kidney Yang
    • Formula: Si Ni Tang (Frigid Extremities Decoction)
  • Heat Transformation:
    • Symptoms: Irritability, dry mouth/throat, insomnia
    • Tongue: Red, scanty coat
    • Pulse: Thin, rapid
    • Treatment Principle: Nourish Kidney Yin, clear deficiency heat
    • Formula: Huang Lian E Jiao Tang (Coptis and Ass-Hide Gelatin Decoction)

6. Jueyin Stage (厥陰)

• Characteristics: Terminal stage; often involves reversal of internal energy and systemic disruption.
• Organs: Pericardium and Liver
• Key Concepts: Terminal conditions, complex pathologies
  • Symptoms: Heat above (chest), cold below (extremities), erratic movements of energy, diarrhea
  • May involve parasitic infections (historically noted to include vomiting roundworms)
  • Tongue: Wiry
  • Treatment Principle: Warm middle, clear heat, expel parasites
  • Formula: Wu Mei Wan (Mume Pill)

Historical Context

• Origin from Han Dynasty (200-210 AD) by Zhang Zhongjing
• Treated both cold-induced diseases and broader pathologies
• Foundation of many modern TCM principles and practices

Summary

• Six Stages Overview: Progression from exterior to interior indicates severity and chronicity.
  • Initial Innate Deficiency or Imbalance can lead to quicker transition to interior stages.
  • Main Treatments: Move exterior—promote sweat (Taiyang), harmonize pivots (Shaoyang), purge interior heat (Yangming), warm and strengthen internal organs (Taiyin, Shaoyin), final systemic corrections (Jueyin).